Robert Koch Institute, Department for Infectious Disease Epidemiology, Respiratory Infections Unit, Berlin, Germany.
Euro Surveill. 2011 Aug 11;16(32):19941.
The threat of avian influenza (AI) viruses to humans in Europe in 2005 prompted the Robert Koch Institute to establish a routine monitoring instrument condensing information on all human AI cases worldwide reported from the World Health Organization (WHO) and other sources into a line list for further analysis. The 235 confirmed AI cases captured from September 2006 to August 2010 had a case fatality rate of 56% (132/235), ranging from 28% (27/98) in Egypt to 87% (71/82) in Indonesia. In a multivariable analysis, odds of dying increased by 33% with each day that passed from symptom onset until hospitalisation (OR: 1.33, p=0.002). In relation to children of 0–9 years, odds of fatal outcome were more than six times higher in 10–19 year-olds and 20–29 year-olds (OR: 6.06, 95% CI: 1.89–19.48, p=0.002 and OR: 6.16, 95% CI: 2.05– 18.53, p=0.001, respectively), and nearly five times higher in patients of 30 years and older (OR: 4.71, 95% CI: 1.56–14.27, p=0.006) irrespective of the country, which had notified WHO of the cases. The situation in Egypt was special in that case number and incidence in children were more than twice as high as in any other age group or country. With this study, we show that data from the public domain yield important epidemiological information on the global AI situation. This approach to establish a line list is time-consuming but a line list is a prerequisite to such evaluations. We thus would like to encourage the placing of a publicly accessible line list of anonymised human AI cases, e.g. directly by WHO. This might enhance our understanding of AI in humans and permit the rapid detection of changes in its epidemiology with implications for human health.
2005 年，欧洲发生禽流感（AI）病毒威胁人类健康事件后，罗伯特·科赫研究所建立了一个常规监测工具，将世界卫生组织（WHO）和其他来源报告的全球所有人类 AI 病例信息汇总到一个列表中，以便进一步分析。该列表包括 2006 年 9 月至 2010 年 8 月期间捕获的 235 例确诊 AI 病例，病死率为 56%（132/235），病死率范围为埃及的 28%（27/98）至印度尼西亚的 87%（71/82）。多变量分析显示，从症状出现到住院治疗的每一天，死亡的几率都会增加 33%（OR：1.33，p=0.002）。与 0-9 岁的儿童相比，10-19 岁和 20-29 岁儿童的死亡风险高出 6 倍以上（OR：6.06，95%CI：1.89-19.48，p=0.002 和 OR：6.16，95%CI：2.05-18.53，p=0.001），而 30 岁及以上患者的死亡风险则高出近 5 倍（OR：4.71，95%CI：1.56-14.27，p=0.006），无论这些病例是来自哪个国家，只要该国家已经向 WHO 通报了这些病例。埃及的情况比较特殊，因为儿童病例数量和发病率都比其他任何年龄组或国家高两倍多。通过这项研究，我们表明，来自公共领域的数据提供了有关全球 AI 情况的重要流行病学信息。建立这样一个列表的方法很耗时，但它是进行此类评估的前提。因此，我们鼓励建立一个公开的匿名人类 AI 病例列表，例如直接由 WHO 建立。这可能会增强我们对人类 AI 的理解，并允许快速检测其流行病学变化，从而对人类健康产生影响。
